Comparison of biopsy indications and preliminary diagnosis, histopathological findings and hi̇stopathological diagnoses of bone marrow biopsy materials from adult patients

Objective: In bone marrow biopsies of adult patients, we aimed to evaluate the demographic characteristics of the patients, clinical preliminary diagnosis, biopsy indication, histopathological findings and final histopathological diagnosis, and as a result, to draw a road map for clinicians and pathologists in the production and evaluation of bone marrow biopsy. Material and Method: In our study, the reports of bone marrow biopsy materials of 900 cases sent to Afyonkarahisar Health Sciences University Medical Pathology Laboratory from the Department of Internal Diseases Hematology between 01. 01. 2017 and 31. 12. 2021 in our archive were retrospectively analyzed. 18 follow-up cases sent with the prediagnosis of insufficient bone marrow material and 184 cases of treatment response were excluded from the study. 698 cases were included in the study. SPSS v26 program was used for statistical evaluation results and analysis, and p<0. 05 level was considered significant. McNemar test was used for clinicopathological agreement. Results: Lymphoma is the most common indication for bone marrow biopsy in patients, and the most common indication was pancytopenia in women, and lymphoma in men. The most frequently asked preliminary diagnosis by the clinic was myeloma, and when the distribution by gender was examined, it was myeloma for both men and women. When evaluated in terms of diagnosis; it was seen that the most common diagnosis was normocellular bone marrow, and when the distribution according to gender was examined, normocellular bone marrow was diagnosed for both men and women. The most common pathological finding was not observed histopathologically in patients diagnosed with normocellular bone marrow and hypocellular bone marrow. Histopathologically, the most common findings consistent with chronic myeloproliferative diseases were seen in patients diagnosed with hypercellular bone marrow. It was observed that the most common diagnosis of hypercellular bone marrow was in the patients who presented with the indication of pancytopenia and bicytopenia and without a preliminary diagnosis. When the agreement was evaluated in terms of clinical prediagnosis and histopathological findings, it was found that there was agreement in the diagnoses of chronic lymphocytic leukemia/small lymphocytic lymphoma, mantle cell lymphoma, marginal zone lymphoma, lymphoplasmocytic lymphoma, aplastic anemia and myelofibrosis. Conclusion:In our study, it was seen that the most common diagnoses were nonneoplastic. Lymphoma, which is the most common indication, was found to be significant in terms of pre-diagnosis and diagnostic compliance, and therefore, bone marrow biopsy can be routinely performed for lymphoma staging. There were patients who were admitted with the indication of bicytopenia and pancytopenia, who were diagnosed with carcinoma infiltration without a previous diagnosis. Factors such as autoimmune diseases and chronic liver diseases may be the cause of pancytopenia in patients with an indication of pancytopenia and a preliminary diagnosis cannot be made, and systemic screening is required for these patients. Histopathologically atypical plasma cells were seen in patients with a previous diagnosis of solid tumor, which may be due to the effect of chemotherapy and radiotherapy. The results of our study will expand the data in the literature and shed light on research on this subject. Keywords:Bone Marrow Biopsy, Indication, Histopathological Findings, Diagnosis, Pre-diagnosis